Provider Demographics
NPI:1518427467
Name:GILL, SURJIT SINGH
Entity Type:Individual
Prefix:
First Name:SURJIT
Middle Name:SINGH
Last Name:GILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 N FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-6064
Mailing Address - Country:US
Mailing Address - Phone:917-957-9450
Mailing Address - Fax:888-745-7138
Practice Address - Street 1:93 N FORDHAM RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-6064
Practice Address - Country:US
Practice Address - Phone:917-957-9450
Practice Address - Fax:888-745-7138
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi